Special investigation: Inside the migrant maternity ward where the NHS is struggling to cope

Walk into Ealing Hospital and you could be forgiven for thinking you were in a foreign land. Looking around the maternity unit, the vast majority of mothers with newborns are from abroad. Most are Indian or Polish.

One woman who recently gave birth at the hospital told me: ‘I was practically the only British woman there. Some of the others didn’t speak a word of English.’

Hardly surprising, given that last week new figures revealed that 80 per cent of the children born at the West London hospital over the previous year were to foreign nationals.

New figures reveal that 80 per cent of the children born at Ealing Hospital over the previous year were to foreign nationals

Of the 3,289 children delivered, an extraordinary 2,655 babies were born to non-British mothers. The statistics also showed that the maternity unit last year dealt with women from a total of 104 different nationalities — an astounding figure. As a result, a team of translators, funded by the taxpayer, has to be on hand around the clock.

The children born to foreign women include 537 babies by Indian mothers — the largest minority ethnic group — 389 Poles, 270 Sri Lankans, 260 Somalis, 200 Afghans and 208 Pakistanis.

In contrast, there were 634 babies with British mothers, including just three from Wales and six from Scotland.

Maternity services at the hospital are under increasing pressure, with a 20 per cent rise in births over the past five years, almost twice the national average — partly due to the fact that foreign-born women generally have more children than their British counterparts. As a result, the hospital has had to take on 32 extra midwives to cope with the boom.

The revelations have inevitably sparked criticism of Britain’s immigration policies, and renewed concern that the NHS is being overwhelmed by an influx of foreign mothers keen to take advantage of free healthcare.

A Daily Mail investigation reveals that births to mothers born outside the UK last year rose to the highest figure since records began in 1969.

They accounted for nearly a quarter — 24.7 per cent — of all live births in 2009. This has increased since 2008, when it was 24.1 per cent.

In 2009, there were 174,174 live births in England and Wales to mothers born outside the UK, compared with 170,834 in 2008.

This
means that nationally, one baby in four is born in the UK to a foreign
mother — twice the level of 1997, when New Labour came to power. In
1990, it was just under 12 per cent.

The latest Office for
National Statistics figures show that in 2009, the three countries which
produced the highest number of births here to mothers from outside the
UK were Pakistan, Poland and India.

Of the 3,289 children delivered at the West London hospital, an extraordinary 2,655 babies were born to non-British mothers (stock image)

Of the local authorities in England, the London borough of Newham recorded the highest percentage of births to mothers born outside the UK in 2009, at 75.7 per cent. Outside London, Slough — which has seen a considerable influx from Eastern Europe — leads the field, with 57 per cent of births to foreign mothers, followed closely by Luton, which has a large Asian population.

Areas such as Peterborough, too, have seen a huge increase in births from Eastern Europeans. There were just three such babies born there in 2000, but almost 200 in 2006.

But it is at Ealing Hospital that truly extraordinary figures have been witnessed. Women who have given birth there in recent times paint a disturbing picture of chaos and squalor.

Beezy Marsh, a 38-year-old former Daily Mail health correspondent, says: ‘I gave birth to my son Bryn at Ealing four years ago.

‘My acute medical care was good. I had a life-threatening condition [major placenta praevia, which can require an emergency Caesarean] and the doctors there basically saved my life. But I was shocked by some of the things I saw.

‘The services were overstretched, with the midwives struggling every day. I monitored the progress of a bloodstained nightgown over the course of five days, hanging forlornly over a shower rail.

‘The cleaners ignored it. The staff never bothered to look. In the end, I donned a pair of surgical gloves and took it to the ward’s dirty linen basket.

‘The post-natal care was dreadful — once you were out of physical danger, the staff didn’t want to know, they had to put all their resources in at the sharp end.

‘The majority of women were not white Caucasian because Ealing hospital is the nearest NHS hospital to Southall, which has a large Asian community, and Ealing is also home to many Poles. You could see the strain of coping with such a diverse population — the curry menu at the hospital was fantastic, far better than the English food on offer.’

Staff clearly encountered difficulties with some patients’ cultural norms. Beezy witnessed a Somali man insist his wife — who had already had two children by Caesarean section — should go home to have a ‘natural’ birth because it was ‘woman’s work’.

'The blood-stained nightgown hung there for days'

‘Doctors begged him not to take her home, explaining that they needed to perform a Caesarean, because her womb was at risk of rupture if she went into labour naturally. They left anyway. It was horrendous.’

Like most maternity units now, it was locked to ensure the safety of newborns, and there were limited visiting hours to ensure mothers got rest and privacy to breastfeed. Yet Beezy recalls: ‘Many relatives were not happy with this, and a rowdy rabble frequently congregated outside the ward doors, pressing the buzzer repeatedly and demanding to come in.

‘On one occasion, approaching midnight, as mums-to-be waddled up and down the ward in their nightwear, I heard a male voice at one end of the ward.

‘A woman was trying to conceal her husband in her bed overnight. When a security guard came to escort him out, the man answered in an Eastern European accent that he did not understand and had wanted to stay the night. Officially, though, no one will say a word against this sort of behaviour.’

Another British mother who experienced the maternity unit at Ealing reiterates the point that because the number of women giving birth there has increased so much — by 20 per cent in five years, remember — that the staff are increasingly unable to care properly for their patients.

Writing on the Mumsnet website, she said: ‘The postnatal care was rubbish. Far too few midwives, I was left in an unchanged bed for hours, no one fed me for hours, I wasn’t given a cot for the baby. If my mum hadn’t been there to fight for me and hold the baby it would have been awful.’

It appears that Ealing is only the thin end of the wedge. The Royal College of Midwives recently warned that maternity units across the country were ‘teetering on the brink’ under the pressure of rising birth rates.

Last year, it emerged that pregnant women were being forced to travel up to 99 miles in order to give birth after being turned away by overstretched maternity units.And almost a quarter of mothers were left alone and frightened during labour because midwives do not have the time to provide one-to-one care.

Maternity services at the hospital are under increasing pressure, with a 20 per cent rise in births over the past five years, almost twice the national average (stock image)

In 2007, Heatherwood Hospital in Ascot had to close for two months so that midwives from there could be moved to Slough, where they were needed to deliver an extra 150 babies to foreign-born mothers over a short period. This had knock-on effects for British mothers at local hospitals.

Cathy Warwick, general secretary of the Royal College of Midwives, warns that maternity units are at ‘breaking point’.

She says that nurses had told her that ‘the service they are giving to women and babies is deteriorating, and that safety is too often being compromised’.

‘The service is teetering; the cracks are beginning to appear. Maternity services are under assault. Midwives cannot carry on working like this day in and day out, often without breaks, and continue to practise safely.’

Warwick blames the rising birth rate for the pressures on NHS maternity services. A key factor is that foreign women tend to have larger families — an average of 2.5 babies compared with 1.84 for UK nationals.

'A woman was trying to conceal a man in her bed'

She is calling for increased resources to cope with the new demand, saying: ‘Maternity services should be geared up to provide safe and high-quality care to the local population, whatever its make-up.

‘All women deserve and should get, safe, high-quality care from the NHS. This is why we are campaigning to ensure that this Government invests in more midwives and puts resources into maternity services.

‘The issue here is not about immigration, it is about resourcing our maternity services to meet the needs of the women it serves.’

It is universally recognised that NHS resources are not infinite, however. When New Labour came to power, the nation spent £1 billion a year on maternity services. Ten years later, that had risen to £1.6 billion.

Some believe the answer lies not in spending more money, but in limiting immigration. The Conservative MP James Clappison, whose constituency is in Hertfordshire, says: ‘The Labour Government has left us with significant challenges after an unprecedented wave of inward migration. The pressures, I’m sure, are being felt all over the place, including in the NHS. I fully support the present Government’s proposals to cap migration.’

Of course no responsible person wishes to stir up xenophobia. Nevertheless, it is surely reasonable to question how Britain will cope with a seemingly ever-increasing number of mothers from other countries using its maternity units.

Despite the burgeoning birth rates, Ealing Hospital denies that its maternity services are under strain.

In 2008, watchdogs at the Healthcare Commission rated its maternity unit as one of the weakest in the country. However, the service has improved in recent years, according to the new health regulator, the Care Quality Commission.

At the end of 2010, it rated Ealing’s maternity unit 7.8 out of 10, on a par with most NHS Trusts.

A spokesman for Ealing Hospital NHS Trust says: ‘As with the rest of the UK, the Trust has seen a steady increase in the birth rate during the past few years. The maternity services at Ealing Hospital NHS Trust are not under strain and the Trust has achieved and maintains good staff-to-mother ratios in the maternity department.’

'Midwives just can't carry on working like this'

Despite this, the hospital admits: ‘We recognise some of the issues raised by mothers over a number of years. We are now about to invest £1.4 million in refurbishing the environment of our maternity unit, and have set up a Maternity Service Liaison Committee made up of past users, with the express aim of getting mothers and midwives to sit down and work out how things can be better.

‘We can’t do anything about our diverse population — that is a fact of life in Ealing, as it is in the rest of London, and we have boosted our translator service to help with cultural and language difficulties.’

Ealing mothers confirm that the influx of foreign women is contributing to a decline towards Third World standards in British maternity care — poor hygiene, over-stretched staff, and chaotic care.

Gallingly, one local community leader says that maternity provision is now better in some of the foreign women’s home countries than at Ealing.

A Catholic priest at the Polish Catholic Community Centre in the borough said he had spoken to many new mothers who were unhappy about their experience at Ealing Hospital.

He said: ‘Some women from Eastern Europe say it is not very good and that the service they would receive in Poland would be better.

‘Doctors are involved much earlier in a woman’s pregnancy in Poland, and the service is more complex and detailed.’

Of course, many Polish families are now returning to their homeland as the recession here makes it difficult to find work. In Poland, they will no doubt avail themselves of a service under less pressure than here.

But what a sad state of affairs they leave behind for the local women of Ealing.